- Medical Professionalism & The Physician Charter
- Choosing Wisely®
The Choosing Wisely® campaign is one of our most well-known initiatives. The goal of the campaign is to reduce waste in the health care system and avoid risks associated with unnecessary treatment. It calls upon leading medical specialty societies and other organizations to identify tests or procedures commonly used in their field whose necessity should be questioned and discussed with patients.
The effort has garnered the participation of over 70 medical specialty societies who have published more than 400 recommendations of overused tests and treatments that clinicians and patients should discuss. The campaign and society recommendations have been included in nearly 300 journal articles and more than 10,000 media articles since the program launched in 2012. The campaign was originally conceived and piloted by the National Physicians Alliance through an ABIM Foundation-funded Putting the Charter into Practice grant in 2009.
To help further advance the campaign, the Foundation administers a grant program with support from the Robert Wood Johnson Foundation. This effort brings together health care organizations from across the country to focus on implementation of at least three Choosing Wisely recommendations, including reducing the use of antibiotics for viral infections by at least 20 percent over nearly three years at participating health systems, hospitals and medical groups in their regions.
The Choosing Wisely website features the lists of recommendations, along with various resources for both patients and physicians, including:
- A list of campaign partners
- Patient-friendly materials created by Consumer Reports that translate the recommendations into plain language for consumers
- Communication education modules to aid physicians in conversations with their patients about overuse and unnecessary medical tests and procedures
- Videos featuring prominent health care leaders on the impact of the campaign
- Stories from the Choosing Wisely newsletter that highlight the work of organizations implementing the campaign at sites across the country
Unnecessary Tests and Procedures in the Health Care System — What Physicians Say about the Problem, the Causes and the Solutions
In early 2014, the ABIM Foundation, with funding from the Robert Wood Johnson Foundation, commissioned a survey conducted by PerryUndem Research/Communication to explore physician attitudes regarding the overuse of medical services in the United States.
The research found that nearly three out of four U.S. physicians say the frequency with which doctors order unnecessary medical tests and procedures is a serious problem for America’s health care system – but just as many say that the average physician orders unnecessary medical tests and procedures at least once a week.
The survey also found that more than half of physicians think they are in the best position to address the problem and have ultimate responsibility for making sure patients avoid unnecessary care. Yet at the same time, more than half the physicians surveyed say they’d give an insistent patient a medical test they knew to be unnecessary.
Additional survey findings include:
- 73 percent of physicians say the frequency of unnecessary tests and procedures is a very or somewhat serious problem.
- 66 percent of physicians feel they have a great deal of responsibility to make sure their patients avoid unnecessary tests and procedures.
- 53 percent of physicians say that even if they know a medical test is unnecessary, they order it if a patient insists.
- 58 percent of physicians say they are in the best position to address the problem, with the government as a distant second (15 percent).
- 72 percent of physicians say the average medical doctor prescribes an unnecessary test or procedure at least once a week.
- 47 percent of physicians say their patients ask for an unnecessary test or procedure at least once a week.
- 70 percent of physicians say that after they speak with a patient about why a test or procedure is unnecessary, the patient often avoids it.
Choosing Wisely in an Era of Limited Resources
The 2012 ABIM Foundation Forum: Choosing Wisely in an Era of Limited Resources focused on how systems, and clinicians working within those systems, can improve care for all patients so our nation might deliver on the promise of affordable and high-quality care for all.
Specific goals of the Forum included:
- Gain an understanding of how health care systems and practices can be responsible for health care outcomes and the cost of care of patient populations.
- Examine the local conditions that affect systems’ ability to become fully accountable.
- Examine how these systems address vulnerable populations, defined as groups of people made vulnerable by their financial circumstances or place of residence; health, age, functional or developmental status; ability to communicate effectively; and personal characteristics such as race, ethnicity and gender.
- Build an understanding of how to frame issues of resource stewardship and quality to the public, patients, physicians, policymakers and the media.
See the 2012 Forum Summary (pdf) for highlights of the meeting discussion and action steps.
Background materials for the 2012 Annual Forum include:
- Innovative Advances in Wise Decision-Making (pdf)
- Key Initiatives to Promote Appropriate Resource Use (pdf)
- 2012 ABIM Foundation Forum Bibliography (pdf)
Choosing Wisely: The Responsibility of Physicians, Patients and the Health Care Community in Building a Sustainable System
Goals of the 2011 Annual Forum: Choosing Wisely: The Responsibility of Physicians, Patients and the Health Care Community in Building a Sustainable System included:
- Exploring why we should care about managing finite resources and responsible health care decision-making.
- Understanding the perspectives and roles of various parties in health care in fixing the problems of waste and unnecessary cost. What are the concrete strategic actions of patient/consumer groups, specialty societies, professional regulators, payers/purchasers and the government in responsible health care decision-making?
- Recognizing the potential intended and unintended consequences of improving decision-making. Would some approaches to better decision-making be better than others for underserved populations and vulnerable populations? How can we proactively serve these populations?
See the 2011 Forum Summary (pdf) for highlights of key ideas and action steps.
Background materials for the 2011 Annual Forum include:
Visit ChoosingWisely.org for more information.